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目的:探讨前颅底肿瘤手术入路,提高手术效果。方法:对37例前颅底肿瘤进行了相应的手术切除,颅面联合入路21例,其中额颅合并鼻侧切开1例,上颌骨内侧部分切除或暂移开切除肿瘤7例,上颌骨切除8例,上颌骨或(和)眶或(和)颌面皮肤切除5例;上颌骨部分或全外旋合并鼻锥转位13例;鼻额翻瓣、额眶入路及面中揭翻各1例。结果:10例良性肿瘤患者均健在,恶性肿瘤患者3、5年存活率分别为81.9%(22/27)、62.9%(17/27)。9年以上无瘤存活1例。结论:除鼻侧切开外不同类型颅面联合入路均能提供良好的肿瘤显露,有利于鼻颅沟通瘤的整块切除。部分或上颌骨全外旋合并鼻锥转位适于切除累及颅底尚未侵及颅内的肿瘤。额鼻共同翻开适于切除额窦发育良好的鼻颅沟通瘤。颅眶入路适于颅眶沟通瘤。面中揭翻应选择应用。
Objective: To explore the surgical approach of anterior skull base tumor to improve the surgical result. Methods: Thirty-seven cases of anterior skull base tumors were resected surgically. Twenty-one craniofacial approachs were performed, of which frontal craniotomy combined with nasal resection in 1 case, medial maxillary partial resection or temporary removal of tumor in 7 cases, maxillary 5 cases of maxillary or (or) orbital or (and) maxillofacial skin excision; 8 cases of maxillary partial or total external rotation combined with nasal cone transposition in 13 cases; nasal flap, frontal orbital approach and facial Revealed in 1 case. Results: All 10 patients with benign tumors were alive. The 3 and 5-year survival rates of patients with malignant tumors were 81.9% (22/27) and 62.9% (17/27), respectively. More than 9 years without tumor survival in 1 case. Conclusion: In addition to the nasal lateral incision of different types of craniofacial approach can provide a good tumor revealed, is conducive to the entire nasal cranial tumor resection. Partial or maxillary total external rotation combined with nasal cone transposition for the removal of the skull base has not been involved in invasion of intracranial tumors. Frontal nose common open suitable for resection of frontal sinus well-developed nasal cranial tumor. Craniofacial approach for cranial orbital tumor. Face to expose should choose to apply.